Infection

, 37:270

Italian Consensus Statement on Management of HIV-Infected Individuals with Advanced Disease Naïve to Antiretroviral Therapy

Authors

    • Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani” IRCCS
  • A. Ammassari
    • Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani” IRCCS
  • C. Torti
    • Clinica Malattie Infettive e TropicaliUniversità degli Studi
  • P. Marconi
    • Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani” IRCCS
  • M. Andreoni
    • Università di Roma “Tor Vergata”
  • G. Angarano
    • Università degli Studi
  • S. Bonora
    • Ospedale Amedeo di SavoiaUniversità degli Studi
  • A. Castagna
    • Università “Vita e Salute”San Raffaele
  • R. Cauda
    • Università Cattolica del Sacro Cuoro
  • M. Clerici
    • Università degli Studi
  • A. d’Arminio Monforte
    • A.O. San PaoloUniversità degli Studi
  • A. De Luca
    • Università Cattolica del Sacro Cuoro
  • G. Di Perri
    • Ospedale Amedeo di SavoiaUniversità degli Studi
  • M. Galli
    • Ospedale L. SaccoUniversità degli Studi
  • E. Girardi
    • Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani” IRCCS
  • A. Gori
    • Ospedale S. GerardoUniversità Milano-Bicocca
  • A. Lazzarin
    • Università “Vita e Salute”San Raffaele
  • S. Lo Caputo
    • Ospedale S.M. Annunziata
  • F. Mazzotta
    • Ospedale S.M. Annunziata
  • F. Montella
    • Ospedale S. Giovanni Addolorata
  • C. Mussini
    • Policlinico UniversitarioUniversità degli Studi
  • C. F Perno
    • Università di Roma “Tor Vergata”
  • M. Puoti
    • Clinica Malattie Infettive e TropicaliUniversità degli Studi
  • G. Rizzardini
    • Ospedale Luigi Sacco
  • S. Rusconi
    • Ospedale L. SaccoUniversità degli Studi
  • V. Vullo
    • Università “La Sapienza”
  • G. Carosi
    • Clinica Malattie Infettive e TropicaliUniversità degli Studi
Consensus Report

DOI: 10.1007/s15010-008-8134-8

Cite this article as:
Antinori, A., Ammassari, A., Torti, C. et al. Infection (2009) 37: 270. doi:10.1007/s15010-008-8134-8

Abstract

Background:

Individuals with advanced HIV infection naïve to antiretroviral therapy represent a special population of patients frequently encountered in clinical practice. They are at high risk of disease progression and death, and their viroimmunologic response following the initiation of highly active antiretroviral therapy may be more incomplete or slower than that of other patients. Infection management in such patients can also be complicated by underlying conditions, comorbidities, and the need for concomitant medications.

Aim:

To provide practical guidelines to those clinicians providing care to HIV-infected patients in terms of diagnostic assessment, monitoring, and treatment.

Conclusions:

The principals of antiretroviral treatment in asymptomatic naïve patients with advanced HIV infection are the same as those applicable to the general population with asymptomatic HIV infection. Naïve patients with advanced HIV infection and a history of AIDS-defining illnesses urgently need antiretroviral treatment, with the choice of antiretroviral regimen and timetable based on such factors as concomitant treatment and prophylaxis, drug interactions, and potential concomitant drug toxicity. Finally, an adequate counseling program – both before and after HIV-testing – that includes aspects other than treatment adherence monitoring is a crucial step in disease management.

Copyright information

© Springer 2009